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The aim of this study is to assess the prescribing pattern for geriatric patients in tertiary care teaching hospital. This is a prospective observational study conducted for a period of 6 months by obtaining ethical clearance from the institutional ethical committee of Togari Veeramallappa Memorial College of pharmacy. The data collected from 200 enrolled subjects with the help of medical records. Out of 200 patients male were n=110 (55%), and female were n= 90 (45%). Prevalence of patients were high in age group of 65-69 years n=101 (50.50%) nearly, 90 patients were complaining of Breathlessness (24.06%) followed by fever (17.37%) and cough (13.36%). The results revealed most of the diseases were related to cardiovascular system n= 86 (26%) followed by respiratory system (18%) and others (14.32%). Most commonly prescribed class of drugs were Antibiotics n=116 (22.28%) followed by Gastro intestinal drugs n=103 (18.85%) and Cardio vascular drugs n=93 (17.05%). Nearly 176 patients (88%) were prescribed with more than 5 drugs. Based on the questionnaire all the patients were following the medication as prescribed by the doctor (100%), most of the patients were not practicing any physical exercises/yoga/meditation (86%), majority of the patients were not feeling any stress (60.50%) and were having regular sleep (72.50%) . The study revealed that most of the prescriptions were rational but further improvement is needed. Further study focused on rationale of drugs based on demographic data, chief complaints along with polypharmacy, physical behavior of the patients.

To evaluate and assess the drug- drug interactions. Methods: A prospective observational study was conducted in department of General medicine, Singareni Collieries Company Limited (SCCL) Main hospital, Kothagudem. A total of 225 subjects were included in the study aged between 18 to 85 yrs Results: Two hundred and ninety two drugs out of 2010 (14.52%) drugs with prescription were observed to have drug-drug interactions. Out of 225 prescriptions, drug-drug interactions were reported in 134 prescriptions which accounts to 59.5% of the population with 292 drug-drug interactions. Out of 134 prescriptions (59.5%), drug-drug interactions were reported in highest number in males (n=73) accounting to 54.4% compared to females (n=61) accounting to 45.52% prescriptions. Out of 134 prescriptions with 292 drug-drug interactions major drug drug interactions were found to be 139 which represents 47.602%, moderate drug drug interactions were found to be 140 which represents 47.945%, minor drug drug interactions were found to be 13 which represents 4.45%.Conclusion: From present study we can conclude that polypharmacy leads to more potential drug-drug interactions. To improve drug safety in this high-risk population, appropriate prescribing and close monitoring of the patients taking drugs with potential drug drug interactions are keys to optimal therapeutic result. Key Words:-Polypharmacy, Chronic diseases, Drug-drug interaction. Access this article online Home page: http://ijptjournal.com/ DOI: http://dx.doi.org/10.21276/ijpt.2019.10.1.2 Quick Response code Received:29.10.18 Revised:12.11.18 Accepted:05.12.18 Corresponding Author Rajani Gunnam Department of Pharmacy Practice, KLR Pharmacy College, Palvancha, Kothagudem, Andhra Pradesh, India. Email:- jyoshnananneni@gmail.com INTR

Lyme disease is a most common vector-borne multisystem disease caused by bacteria Borreliaburgdorferi, in the United States, Europe and Asia and is transmitted to humans by the bite of the Ixodes (deer) tick. The disease may occur most frequently during spring, summer, May, mid-October and early November and untreated infection can spread to other parts of the body within days or weeks, causing more serious skin, neurologic, cardiac and joint abnormalities and over months or years, oligo-articular arthritis, peripheral neuropathy, or encephalopathy. The aim of our article primarily reviews disease’s complications and summarizes the, pathogenesis, clinical features, epidemiology, diagnosis, treatment and prevention of the chronic disease. Key Words:-Lyme disease, Borreliaburgdorferi, Ixodes (deer) tick, Complications.

The present investigation has been determined the some hematological parameters changes following the lead acetate toxicity and the collaboration of thiamine (vitamin B1) in calming of these changes in male rabbits . Thirty local breed male were used and randomly partitioned into three equivalent groups (n=10). Group G1served as control, took distilled water, group G2 reserved lead acetate (5 mg/kg B.W), group G3 reserved thiamine(100 mg each animal with lead acetate (5 mg/kg B.W),orally every 24hours (for 6 weeks),the samples were collected randomly from four animals at time intervals through 1, 3 and 6 weeks. The results revealed significant decline of RBC count, Hb concentration and PCV percentage. Whereas, significant increase of total WBC count and neutrophil count, and in addition there are significant decline of lymphocytes. On other hand, the outcomes demonstrated that splashing vitamin B1 had an essential effective in enhancing the harmful impacts of lead acetate. It can be concluded that, the exposure to lead compounds leads to many distinct alternation in blood tissue due to toxic effects, also, proved that thiamine have an important efficient role in improving the toxicological changes resulted from lead acetate poisoning. Key Words:-Lead poisoning, Thiamin, Rabbits, blood tissue, Neutrophil.

The study was aimed to determine the adherence of medication taking behaviour and associated factors among the
adult cardiovascular patients in SCCL Main Hospital, Kothagudem. To assess the demographic details and to know the
Medication Adherence among Cardiovascular patients. An observational prospective interview-based study of 200 adult
cardiovascular/hypertensive patients was conducted for a period of six months. Medication adherence measured using an
Eight Item Morisky Medication Adherence Scale. Data collected by interview method using structured questionnaire. Data
analysed using simple statistical methods (i.e., Mean values, standard deviations, and percentages were used for data
representation).Out of 200 cases, 128 were male, 72 were females with the percentages 36% and 64% respectively with
cardiovascular disease. Age group 51-60 and 41-50 among males and females were with highest number of cardiovascular
diseases with percentages 54.68% and 30.55% respectively compared to all other age categories. In this study, literacy rate
was 61% among were illiterates and about 39% of subjects were literates. Number of drugs/day- 0.5% of subjects receives 3
drugs per day, 3% of subjects receive 4 drugs per day, and 96.5% of subjects receive more than 4 drugs. The mean and
standard deviation (SD) value for total number of subjects was 40 ±76.53. About 72% of subjects are non-alcoholics
whereas 28% were alcoholics and about 87% of subjects were non-smokers whereas 13% were smokers. Among 200
cardiovascular subjects,high adherence was found in 27 (24%) patients, moderate adherence was in 125 (62.5%) patients
and poor adherence was seen in 48 (13.5%) patients according to the 8-MMAS influenced by age, educational status,
number of drugs per day and forgetfulness, alcohol intake and smoking habits. Hence, medication adherence among
cardiovascular patients in the present study is moderate.

The aim of the present study is to analyze the drug utilization pattern in chronic kidney disease patients who was
undergoing hemodialysis. To study and describe the drug utilization pattern of assorted categories of medication together
with high blood pressure, DM, and different co-morbid conditions in patients with chronic kidney disease (CKD). A
prospective, observational and descriptive study was conducted for a period of six months. A total of 41 subjects were
included in the study aged between 18 to above 70 years and data was collected and assessed for drug prescription pattern
and its categories. Among 41 patients, number of males patients (29 patients, 70.73%) and female patients (12 patients,
29.26%). A total of 94 drugs were prescribed to 41 patients who were part of the study. Each patient received an average of
7.5 drugs. Most of the patients were in the age group of 45-55 years (18 patients, 43.9%) with a mean age of 55.17 ±10.02
years. Anemia was the most common hematological manifestation observed in our study population which affected 36
patients (87.8%). Hypertension has been reported to occur in 80% to 90% of patients with Chronic Kidney Disease. This
study results shows that the overall drug utilization pattern of chronic kidney disease shows higher utilization of drugs were
hypertensive drugs (83 prescriptions, 88.29%),followed by anti-anemic drugs (67 prescriptions,71.27%), vitamins and
minerals (59 prescriptions,62.76%), antiulcer drugs (30 prescriptions,31.91%) were most frequently used . In conclusion, it
has been found that the management of chronic kidney disease in nephrology department of Singareni Collieries Company
Limited, Main hospital, is with the rational utilization of medicines which is based on clinical knowledge, expertise and the
guidelines accessible in the field of nephrology practice.